Which physical exam finding is typical of a hip fracture?

Which physical exam finding is typical of a hip fracture?

• A. External rotation without shortening
• B. Painful knee with straight leg
• C. Shortened and externally rotated leg with tenderness and swelling
• D. Normal leg with no deformity

Answer: (C)

In a hip fracture, the leg typically ends up shortened and externally rotated because the broken proximal femur and surrounding muscle spasm pull the limb and create displacement. Tenderness and swelling are felt over the hip or groin, and the patient often cannot bear weight on that leg. This combination—shortened, externally rotated limb with focal tenderness and swelling—is the classic exam finding for a hip fracture. Other choices don’t fit as well because a painful knee with a straight leg suggests knee or distal pathology rather than a proximal femur fracture; external rotation without shortening can occur in some hip injuries but the shortening is a hallmark feature; and a normal leg with no deformity would be unlikely in a true fracture.

In a hip fracture, the leg typically ends up shortened and externally rotated because the broken proximal femur and surrounding muscle spasm pull the limb and create displacement. Tenderness and swelling are felt over the hip or groin, and the patient often cannot bear weight on that leg. This combination—shortened, externally rotated limb with focal tenderness and swelling—is the classic exam finding for a hip fracture.

Other choices don’t fit as well because a painful knee with a straight leg suggests knee or distal pathology rather than a proximal femur fracture; external rotation without shortening can occur in some hip injuries but the shortening is a hallmark feature; and a normal leg with no deformity would be unlikely in a true fracture.